Sydenham chorea, also known as rheumatic chorea, is a neurological disorder that is a major manifestation of acute rheumatic fever, a complication of untreated or inadequately treated group A streptococcal infection, such as strep throat or scarlet fever. Here are some key points about Sydenham chorea:
- Characteristics and Symptoms:
- Sydenham chorea is characterized by rapid, uncoordinated jerking movements primarily affecting the face, hands, and feet.
- It may also involve muscle weakness, emotional instability, and uncoordinated, involuntary movements that can interfere with speaking, eating, and daily activities.
- The disorder is more common in children, especially girls, and typically manifests several months after the initial streptococcal infection.
- Pathophysiology:
- The exact mechanism is not fully understood, but it's believed to be an autoimmune response. Antibodies produced by the immune system to fight the streptococcus bacteria mistakenly attack parts of the brain, particularly the basal ganglia, which are involved in movement control.
- Diagnosis:
- Diagnosis is primarily clinical, based on the characteristic symptoms and a history of recent streptococcal infection.
- Tests to support the diagnosis may include throat cultures, blood tests for streptococcal antibodies, and imaging studies like MRI to rule out other causes of the symptoms.
- Treatment:
- Treatment involves managing the symptoms and may include medications such as antipsychotics or anticonvulsants to control movements.
- Antibiotics like penicillin are used to treat the underlying streptococcal infection and to prevent recurrence of rheumatic fever.
- Supportive care, including bed rest and physical therapy, may be beneficial.
- Prognosis:
- The condition usually resolves on its own over a period of weeks to months, but it can last longer. Most children recover completely, but in some cases, the chorea may recur or persist.
- In some instances, Sydenham chorea may be the first indication of rheumatic fever, necessitating further medical evaluation for potential cardiac involvement.
- Prevention:
- Prevention of Sydenham chorea involves the prompt and appropriate treatment of streptococcal infections with antibiotics to prevent the development of rheumatic fever.
Understanding and awareness of Sydenham chorea are important, especially in regions where rheumatic fever is more prevalent. Early diagnosis and treatment of streptococcal infections are key in preventing this and other complications of rheumatic fever.